双醋瑞因联合玻璃酸钠治疗膝骨关节炎疗效观察

目的：评价双醋瑞因联合玻璃酸钠治疗骨关节炎的临床疗效。方法：采用回顾性临床对照研究方案设计，65例膝骨关节炎患者应用关节腔内注射玻璃酸钠治疗为对照组，69例膝骨关节炎患者在玻璃酸钠基础治疗的同时合用双醋瑞因6个月作为联合治疗组，通过VAS评分、WOMAC评分、ESR和CRP在治疗前、治疗后1个月、3个月和后3个月3个时段四个时间断面的病情改变作为疗效判断指标。结果：与治疗前相比，两组的关节触痛、20米步行痛评分、WOMAC评分、ESR和CRP有明显改善（P〈0．001）；在治疗后的3个月，各个观察指标联合治疗组明显优于对照组（X^2=5．256，P〈0．05）；在治疗后的第2、3个月和治疗后的后3个月两个时段，应用NSAIDs的患者例数上，联合治疗组明显少于对照组（P=0．022；X^2=10．428，P=0．001），在治疗初的1个月内两组无差异（X^2=0．137，P=0．711），并且未发生严重不良事件。结论：双醋瑞因和玻璃酸钠二者对骨关节炎治疗都有临床疗效；在对OA采用玻璃酸钠治疗的基础上，同时合用和维持治疗，临床疗效更持久有效，值得临床推广。

The Observation of Clinical Effect of Therapeutic Alliance of Diacerein and Sodium Hyaluronate in Osteoarthritis Patients

Objective： To evaluate the clinical efficacy of therapeutic alliance of diaeerein and sodium hyaluronate in osteoarthritis patients. Methods： There were 134 cases of knee osteoarthritis enrolled who were fulfilled with the American College of Rheumatology criterias of knee osteoarthritis, and they were divided into two groups： therapeutic alliance group and control group. Sixty-nine cases of knee osteoarthritis as therapeutic alliance group were given diaeerein and sodium hyaluronate and 65 cases as control group only were given sodium hyaluronate. All patients with knee osteoarthritis were observed and followed up for six months. Results： The joint pain and pain on walking for 20 meters （visual analog scale, VAS） and WOMAC score and ESR and CRF of 134 cases of kneed osteoarthritis patients were significatively improved compared with baseline （P〈0. 001）. The joint pain and pain on walking for 20 meters and WOMAC score and ESR and CRF of therapeutic alliance group were greatly improved compared with these of control group at the last 3 months after treatment and no difference at the 1st month and the second and the 3rd month. The number of patients with knee osteoarthritis given NSAIDs was not so many as among therapeutic alliance group com- pared with that of control group at last 5 months （X^2 = 5. 256, P= 0. 022; X^2 = 10. 428, P= 0. 001） but Similar at the 1st month （X^2= 0. 137, P= 0.711）. Conclusion： Clinical efficacy of knee osteoarthritis patients with treatment on diacerein and sodium hyaluronate is better than that of sodium hyaluronate only.